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   2001| July-September  | Volume 49 | Issue 3  
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Finding the retinal break in rhegmatogenous retinal detachment
Sandeep Saxena, Harvey Lincoff
July-September 2001, 49(3):199-202
The development of subretinal fluid is governed by a limited number of anatomical factors and gravity. As a result, rhegmatogenous retinal detachments form in a predictable manner around the retinal break of their origin. The shape of the detachments points to the position of the break. The purpose of this review is to describe the characterstic contours of subretinal fluid in rhegmatogenous retinal detachments, and to highlight some rules and methodology which can help in the detection of the retinal break in phakic, psuedophakic and recurrent retinal detachments.
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New perspectives in ocular surface disorders. An integrated approach for diagnosis and management
Virender S Sangwan, Scheffer C.G.Tseng
July-September 2001, 49(3):153-168
The cornea, conjuctiva and the limbus comprise the tissues at the ocular surface. All of them are covered by stratified, squamous, non-keratinizing epithelium and a stable tear film. The ocular surface health is ensured by intimate relationship between ocular surface epithelia and the preocular team film. There are two types of ocular surface failure. The first one is characterized by squamous metaplasia and loss of goblet cells and mucin expression. This is consistent with unstable tear film which is the hallmark of various dry-eye disorders. The second type of ocular surface failure is characterized by the replacement of the normal corneal epithelium in a process called limbal stem cell deficiency. It is essential to establish accurate diagnosis for appropriate management of complex ocular surface disorders. There has been considerable advancement in the understanding of the pathophysiology of ocular surface disease. Management has improved with introduction of the limbal stem cell concept and use of amniotic membrane transplantation.
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Suprachoroidal haemorrhage. Secondary management
Yog R Sharma, Amit Gaur, Raj V. Azad
July-September 2001, 49(3):191-192
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Efficacy of topical and systemic itraconazole as a broad-spectrum antifungal agent in mycotic corneal ulcer. A preliminary study
Pankaj K. Agarwal, Pranatosh Roy, Amitava Das, Anita Banerjee, Prasanta K. Maity, Asit R. Banerjee
July-September 2001, 49(3):173-176
Purpose: To evaluate the efficacy of topical (1%) and systemic itraconazole against common fungi such as Aspergillus and other filamentous fungi that cause mycotic corneal ulcer. Methods: A prospective randomised, controlled study was done in 54 clinically suspected cases of fungal keratitis of which 44 were culture proven. Half the cases (n=27) with superficial involvement were treated with only topical itraconazole (1%) and the other half were treated with both topical and systemic itraconazole. Results:Aspergillus, Penicillium and Fusarium were the most common fungi isolated. The ulcer resolved in 42 eyes (77%) and 12 eyes (23%) did not respond well to treatment. Four of 12 non-responding eyes were caused by Fusarium species. Conclusion: Itraconazole, given either topically or systemically, is effective in treating mycotic corneal ulcers.
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Ocular fireworks injuries. clinical features and visual outcome
Sudesh K Arya, Summet Malhotra, Sanittar P Dhir, Sunandan Sood
July-September 2001, 49(3):189-190
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Comparison of external dacryocystorhinostomy and 5-fluorouracil augmented endonasal laser dacryocystorhinostomy. A Retrospective review
Patrick Watts, A Raghu Ram, Ranjit Nair, Huw Williams
July-September 2001, 49(3):169-172
Purpose: To compare the success rates of external dacryocystorhinostomy (EXT-DCR) with 5-fluorouracil (5-FU) augmented endonasal laser dacryocystorhinostomy (ENL-DCR) and to record the complications associated with 5-FU augmented ENL-DCR Materials and Methods: This was a retrospective non-randomised study. Forty-one patients with primary acquired nasolacrimal duct obstruction underwent an EXT-DCR (19 patients) or an ENL-DCR (22 patients) over a 3-year period. A Holmium YAG laser (Ho:YAG) was used in the latter group of patients. Silicone tubes intubated in all patients were removed at three months. 5-FU was applied intraoperatively at the site of the ostium in the ENL-DCR patients. The median follow-up was 12 months (range 3-24 months) for the ENL-DCR group and 22 months (range 6-28 months) for the EXT-DCR group. The patency of the lacrimal system and the severity of epiphora were assessed at a final-review. Results: The median age of the EXT-DCR group was 77 years (range 53-87) and that of the ENL-DCR group was 71 years (range 23 to 84). There were 12 female patients in the former group and 19 in the latter. The percentage of success in the EXT-DCR group was 94.7% (95% confidence interval (CI) = 75.4-99.1) = ), and 63.6% in the ENL-DCR group (95% CI= 43.0-80.3). The confidence interval for the difference of 31.1% was 5.6-52.2. There was a statistically significant difference between the two groups, p=0.024 (Fisher exact test). Conclusions: These data suggest that EXT-DCR provides better results than 5-FU augmented ENL-DCR. However, ENL-DCR is the procedure of choice in certain circumstances such as in elderly, frail or medically unfit patients. Our results of 5-FU augmented ENL-DCR compare favourably with other published series.
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Anterior capsular staining with trypan blue for capsulorhexis in mature and hypermature cataracts. A preliminary study
Kulin Kothari, Sunil S Jain, Nikunj J Shah
July-September 2001, 49(3):177-180
Purpose: To study the efficacy and safety of 0.1% Trypan Blue dye to stain the anterior capsule for capsulorhexis in mature and hypermature cataracts. Methods: This preliminary study included 25 eyes of 25 patients with a unilateral mature or hypermature cataract, including one case of traumatic mature cataract. In all these cases 0.2ml of 0.1% trypan blue dye was used to stain the anterior capsule. The efficacy and safety of the dye was evaluated on the basis of intraoperative and postoperative observations. Results: In all 25 eyes the capsulorhexis was completed. There was peripheral extension of the capsulorhexis in the eye with traumatic cataract and the stained edge of the anterior capsule helped identification and redirection of the capsulorhexis. Successful phacoemulsification with intraocular lens implantation was performed in all eyes. Adverse reactions related to the dye such as raised intraocular pressure, anterior chamber inflammation and endothelial damage were not observed in the immediate postoperative period or at the end of mean follow-up of 3 months. Conclusion: Trypan blue dye staining of the anterior capsule appears to be a very useful and safe technique that simplifies capsulorhexis in mature and hypermature cataracts.
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Subconjunctival adult bancroftian filarial worm
Mayank A Nanavaty, Ambarish J Nanavaty, Jitendra D Lakhani, Sucheta J Lakhani, Abhay R Vasavada
July-September 2001, 49(3):195-196
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Evaluation of immunoperoxidase staining technique in the diagnosis of Acanthamoeba keratitis
Savitri Sharma, Sreedharan Athmanathan, Ata-Ur-Rasheed , Prashant Garg, Gullapalli N Rao
July-September 2001, 49(3):181-186
Purpose: We describe a simple procedure of Immunoperoxidase (IP) technique, using indigenously raised antibody, to screen corneal scrapings for Acanthamoeba cysts and trophozoites. This study sought to determine the utility of this test in the diagnosis of Acanthamoeba keratitis. Methods: A high titre polyclonal antibody against a local clinical isolate (axenic) of Acanthamoeba species (trophozoite lysate antigen) was raised in rabbits and used for standardization of IP technique for corneal scrapings. Twenty two smears of corneal scrapings, collected from patients showing Acanthamoeba cysts in corneal scrapings stained with calcofluorwhite (pool-1) and patients showing no cysts in similar scrapings (pool-2), were coded and stained by IP technique by a masked technician. All 22 patients had also been tested for bacteria, fungus, and Acanthamoeba in their corneal scrapings by smears and cultures. IP stained smears were examined for organisms including cysts and trophozoites of Acanthamoeba and background staining by two observers masked to the results of other smears and cultures. The validity of the IP test in detection of Acanthamoeba cysts and trophozoites was measured by sensitivity, specificity, positive predictive value and negative predictive value in comparison (McNemar test for paired comparison) with calcofluor white staining and culture. Results: Based on the readings of observer 1 and compared to calcofluor white staining, the IP test had a sensitivity of 100%, a specificity of 94%, positive predictive value of 80% and negative predictive value of 100%. When compared to culture, the values were 83%, 100%, 100% and 94% respectively. Trophozoites missed in calcofluor white stained smears, were detected in 2 out of 6 cases of culture-positive Acanthamoeba keratitis. The Kappa coefficient of interobserver agreement was determined as fair (30.4%). Conclusion: The immunoperoxidase technique is a simple and useful test in the diagnosis of Acanthamoeba keratitis. This can supplement the culture results.
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Magnitude of the problem of retinopathy of prematurity. Experience in a large maternity unit with a medium size level-3 nursery
Sara Varughese, Sapna Jain, Nidhi Gupta, Saroj Singh, Vineet Tyagi, Jacob M Puliyel
July-September 2001, 49(3):187-188
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Retinitis pigmentosa patients with sickle cell disease and dextrocardia and situs inversus syndrome
Chakravarthi Madhavan, Pramod Bhende, Lekha Gopal, Sengamedu B Vasanthi, Govindasamy Kumaramanickavel
July-September 2001, 49(3):193-195
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Locating the retinal break(s) in rhegmatogenous retinal detachment: The first step in successful management
Lingam Gopal
July-September 2001, 49(3):149-150
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An unusual case of a retained metallic arrowhead in the orbit and sphenoidal sinus
Himadri Datta, Krishnendu Sarkar, Pradeep R Chatterjee, Aloke Kundu
July-September 2001, 49(3):197-198
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Ocular surface failure is treatable
Jagiit S Saini
July-September 2001, 49(3):151-152
  2,804 7 1
A letter
Santhan KS Gopal
July-September 2001, 49(3):203-203
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A prospective study of 413 cases of lens-Induced glaucoma in Nepal
Shyam B Andhare
July-September 2001, 49(3):204-204
  2,137 0 -